van Brakel W H, Khawas I B, Gurung K S, Kets C M, van Leerdam M E, Drever W
Green Pastures Hospital, Pokara, Nepal.
Int J Lepr Other Mycobact Dis. 1996 Sep;64(3):287-98.
We conducted an intra- and inter-tester agreement study of three sensory screening tests used in nerve function assessment of leprosy patients: the Semmes-Weinstein monofilament (SWM) test, moving 2-point discrimination (M2PD), and the pin prick test. The weighted kappa (Kw) statistic was used as the reliability coefficient. The SWM had intra-observer Kws ranging from 0.83 to 0.92 and inter-observer Kws ranging from 0.76 to 0.89. The M2PD had intra- and inter-tester Kws ranging from 0.75 to 0.82 and 0.54 to 0.82, respectively. Inter-tester agreement for the pin prick test ranged from 0.45 to 0.85. There was evidence that the main source of variability between testers was testing skill and experience. Among the experienced physiotechnicians there was no significant difference between intra- and inter-tester reliability. We conclude that reliability of the SWM test was very good, closely followed by the M2PD test. Reliability of the pin prick test was less good than that of the SWM and M2PD, making it less suitable for serial testing.
我们针对用于麻风病患者神经功能评估的三项感觉筛查测试开展了一项测试者内部及测试者间一致性研究,这三项测试分别为:Semmes-Weinstein单丝(SWM)测试、移动两点辨别觉(M2PD)测试以及针刺觉测试。加权kappa(Kw)统计量被用作可靠性系数。SWM测试者内部的Kw值范围为0.83至0.92,测试者间的Kw值范围为0.76至0.89。M2PD测试者内部及测试者间的Kw值范围分别为0.75至0.82以及0.54至0.82。针刺觉测试的测试者间一致性范围为0.45至0.85。有证据表明,测试者之间变异性的主要来源是测试技能和经验。在经验丰富的物理治疗师中,测试者内部和测试者间的可靠性没有显著差异。我们得出结论,SWM测试的可靠性非常好,其次是M2PD测试。针刺觉测试的可靠性不如SWM和M2PD测试,不太适合进行系列测试。